Journal of Primary Care and Community Health最新文献

{"title":"The Burden of Comorbid Depression and Type 2 Diabetes: An Empirical Study Using Commercial Insurance Data.","authors":"SangNam Ahn, Gang Han, McKenzie Beck, Wan-Ling Hsu, Samuel D Towne, Matthew Lee Smith, Marcia G Ory","doi":"10.1177/21501319251336629","DOIUrl":"https://doi.org/10.1177/21501319251336629","url":null,"abstract":"<p><strong>Introduction: </strong>Despite rising rates of depression and diabetes, assessments of depression's burden on diabetes management and its economic burden remain limited. In this study, we evaluate the burden of depression on diabetes management and quantify the financial implications of comorbid depression and diabetes.</p><p><strong>Methods: </strong>We performed propensity score matching on Texas commercial claims data (2016-2019) to match type 2 diabetes patients with depression (n = 613) to those without (n = 583). Depression flagged in 2016/2017 indicated initial depression, and an A1C level of ≥8% in 2018/2019 indicated follow-up uncontrolled diabetes. Healthcare costs included total, diabetes-related, outpatient, and inpatient costs incurred during 2018/2019.</p><p><strong>Results: </strong>A depression flag in the initial period was linked to a 2.7 percentage point increase (<i>P</i> = .031) in the probability of having an A1C level of ≥8% in the follow-up, compared to individuals without a depression flag. Having both a depression flag and uncontrolled A1C in the initial period was associated with $2,037 higher total medical costs (<i>P</i> = .004), $494 higher diabetes-related costs (<i>P</i> = .020), and $336 higher outpatient costs (<i>P</i> = .008) in the follow-up, compared to the respective averages of $6,900, $474, and $583 for individuals without a depression flag or uncontrolled A1C.</p><p><strong>Conclusions: </strong>Our findings highlight the detrimental effect of depression on uncontrolled diabetes and the subsequent increase in healthcare costs. Further research is warranted to determine the effectiveness of proactive treatments for depression in managing diabetes, improving glycemic control, and reducing healthcare costs.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251336629"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Problematic TikTok Use and Mental Health Issues: A Systematic Review of Empirical Studies.","authors":"Lakshit Jain, Luis Velez, Surya Karlapati, Mary Forand, Rajasekhar Kannali, Rao Ahmed Yousaf, Rizwan Ahmed, Zouina Sarfraz, Pearl A Sutter, Christian Anthony Tallo, Saeed Ahmed","doi":"10.1177/21501319251327303","DOIUrl":"10.1177/21501319251327303","url":null,"abstract":"<p><strong>Background: </strong>Since its launch in 2017, TikTok has rapidly emerged as a major player in the digital landscape, amassing over a billion active users. Its engaging features have raised concerns about potential problematic use and negative mental health outcomes. Despite increasing scholarly attention, a consolidated understanding of TikTok's problematic use potential and implications remains elusive This systematic review synthesizes empirical research on problematic TikTok use and its impact on mental health.</p><p><strong>Methods: </strong>This review followed PRISMA Statement 2020 guidelines and conducted a comprehensive search across PubMed, Embase, Scopus, Web of Science, and PsycINFO databases until July 10, 2024. Keywords included terms related to TikTok use, addiction, and problematic use. Studies were included based on empirical focus and publication in peer-reviewed journals. Data extraction comprised study characteristics, measures of TikTok problematic use, and related mental health outcomes. Quality assessment used JBI, Cochrane's RoB 2, MMAT, CASP, and NOS tools. The protocol was registered in OSF: https://osf.io/cjf97.</p><p><strong>Results: </strong>This review included 26 studies, involving a total of 11 462 participants. The pooled prevalence of TikTok use was estimated at 80.19%, with the highest rates observed among people aged 18 to 29 years, where it reached 85.4%. Frequent use of TikTok was closely linked with an increase in symptoms of anxiety and depression, especially in users aged under 24 years. Female users were more likely to experience problematic TikTok use, with 67.3% of such cases found among female university students. Moreover, higher addiction scores were noted among individuals from lower socioeconomic backgrounds and those who had higher levels of neuroticism.</p><p><strong>Conclusion: </strong>The findings of this review highlight the growing concern surrounding the impact of problematic TikTok use on mental health, particularly among younger and more vulnerable populations. It is imperative for stakeholders to prioritize the integration of digital literacy and media literacy into educational curricula. Moreover, the involvement of caregivers through guided mediation and the establishment of clear usage parameters could play a crucial role in managing screen time, particularly for younger users. To improve the current landscape of empirical research, longitudinal and interventional research is warranted.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251327303"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Long-Term Health-Related Quality of Life in Individuals With Prior SARS-CoV-2 Infection: A 12-Month Prospective Study.","authors":"Ali A Weinstein, Leyla de Avila, Maria Stepanova, Jillian K Price, Carey Escheik, Lynn H Gerber, Zobair M Younossi","doi":"10.1177/21501319251342650","DOIUrl":"10.1177/21501319251342650","url":null,"abstract":"<p><strong>Objective: </strong>To identify predictors of clinically meaningful declines in health-related quality of life (HRQoL) among COVID-19 patients over a 12-month period in a prospective, natural history investigation.</p><p><strong>Methods: </strong>We conducted a longitudinal study involving individuals who had tested positive for SARS-CoV-2, assessing various factors and their impact on HRQoL after 12 months. Key potential predictors examined included demographic information, medical history, and symptom reporting. HRQoL was measured using the validated EuroQoL Dimension 5 level scale at baseline and at the 12-month follow-up.</p><p><strong>Results: </strong>The analysis revealed that shortness of breath, a diagnosis of COPD, lower BMI, and a history of anxiety at the initial visit were all significantly associated with clinically meaningful worsening of HRQoL at 12 months. Specifically, individuals with these factors experienced more pronounced declines in HRQoL compared to those without. Notably, the small number of COPD cases within our sample (4 total) limited the reliability of this predictor.</p><p><strong>Conclusions: </strong>Shortness of breath, lower BMI, and a history of anxiety are important predictors of deteriorated HRQoL in COVID-19 patients over the long term. Although the association with COPD is less reliable due to sample size limitations, these findings highlight the need for targeted interventions and continued support for patients exhibiting these risk factors to improve long-term HRQoL outcomes. Future research with larger samples is needed to confirm these results and further investigate the role of these factors in post-COVID HRQoL declines.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251342650"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Care Physician Use of Elastic Scattering Spectroscopy on Skin Lesions Suggestive of Skin Cancer.","authors":"Stephen P Merry, Ivana T Croghan, Kimberly A Dukes, Brian C McCormick, Gerard T Considine, Michelle J Duvall, Curtis T Thompson, David J Leffell","doi":"10.1177/21501319251344423","DOIUrl":"10.1177/21501319251344423","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the performance of noninvasive, elastic scattering spectroscopy, algorithm-powered device (DermaSensor) to detect melanoma and basal and squamous cell cancers in the primary care setting.</p><p><strong>Patients & methods: </strong>DERM-SUCCESS, a blinded, prospective, multicenter pivotal study, enrolled adult patients between August 17, 2020, and December 9, 2021, with lesions that their primary care physicians (PCPs) suspected of skin cancer at clinics in the US (n = 18) and Australia (n = 4). These lesions were assessed by PCPs and scanned with the DermaSensor device. Biopsy specimens were collected, and histopathologic analysis was performed by dermatopathologists. The diagnostic performance of the device, dermatopathologist discordance, and subgroup analyses of clinical interest were calculated.</p><p><strong>Results: </strong>Of the 1579 skin lesions enrolled, dermatopathologic analysis identified 224 (14.2%) cancers. Device sensitivity was 95.5% (95% CI, 91.7%-97.6%) overall and 96.3% (92.9%-98.4%) for patients in the FDA-approved age group 40 years and older (90.2% for melanoma, 97.8% for basal cell carcinoma, and 97.7% for squamous cell carcinoma). Device specificity was 20.7%. The negative predictive value was 96.6%, and the positive predictive value was 16.6% (NNB 6). The device misclassified as \"<i>monitor</i>\" rather than \"<i>investigate further</i>\" 4 keratinocyte carcinomas and 4 melanomas in patients aged 40 years or older (n = 8, 0.5% of lesions, 3.7% of cancers biopsied).</p><p><strong>Conclusions: </strong>The DermaSensor device is an easy-to-use, point-of-care, hand-held skin cancer adjunctive diagnostic device with high sensitivity and NPV to help inform PCP decision-making about skin lesions suspicious for cancer that need further evaluation and those that may be monitored.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251344423"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative Adverse Childhood Experiences and Frequency of Substance Use Among US High School Students.","authors":"Sunday Azagba, Galappaththige S R de Silva, Todd Ebling","doi":"10.1177/21501319251346102","DOIUrl":"10.1177/21501319251346102","url":null,"abstract":"<p><p>Adverse childhood experiences (ACEs) can have lasting effects into adulthood. This study examines the relationship between ACEs and the frequency of substance use among high school students in the United States. Data were drawn from the 2023 Youth Risk Behavior Survey, a nationally representative survey of high school students. A cumulative ACE score was calculated based on 8 self-reported lifetime experiences. Multinomial logistic regression models were used to analyze the association between cumulative ACEs and substance use (alcohol, binge drinking, cannabis, and e-cigarettes). A significant positive association was found between cumulative ACEs and substance use. Higher ACE scores were associated with greater odds of substance use across all categories. Specifically, cumulative ACEs were associated with more frequent alcohol use (OR = 1.89, 95% CI = 1.48, 2.43), binge drinking (OR = 1.69, 95% CI = 1.40, 2.05), cannabis use (OR = 1.81, 95% CI = 1.65, 1.99), and e-cigarette use (OR = 1.89, 95% CI = 1.78, 2.00). Similar results were observed for occasional alcohol use (OR = 1.47, 95% CI = 1.31-1.66), binge drinking (OR = 1.53, 95% CI = 1.36-1.72), cannabis use (OR = 1.26, 95% CI = 1.01-1.57), and e-cigarette use (OR = 1.60, 95% CI = 1.32-1.94). This study highlights the significant associations between ACEs and substance use behaviors among adolescents. Addressing ACEs through comprehensive strategies, such as fostering supportive relationships, may be beneficial and promote healthier development.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251346102"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evaluation of the Decline in Primary Care Physician Visits, 2010 to 2021.","authors":"Anuradha Jetty, Marie Ezran, Alison N Huffstetler, Yalda Jabbarpour","doi":"10.1177/21501319251321618","DOIUrl":"10.1177/21501319251321618","url":null,"abstract":"<p><strong>Introduction: </strong>Primary care is the backbone of the United States healthcare system, yet it continues to be underfunded and inaccessible to many. Previous studies explored primary care visit patterns until 2016, leaving gaps in our understanding of how recent factors like state Medicaid expansions, the Coronavirus Disease 2019 (COVID-19) pandemic, and population growth have influenced these patterns. Hence, the objective of the current study was to analyze the trends in primary care visits provided by outpatient clinicians over time and by visit type and contextualize study findings within the changing healthcare landscape.</p><p><strong>Methods: </strong>The Medical Expenditure Panel Survey data (2010-2021) were used to examine trends in the total number and share of ambulatory, preventive, acute, and chronic care visits and investigate sociodemographic factors associated with a given clinician visit. The outcome variable was the clinician type: Primary Care Physicians (PCPs), Internal Medicine (IM) subspecialists, and Nurse Practitioners or Physician Assistants or Registered Nurses (NP/PA/RNs). Explanatory variables included gender, age, race/ethnicity, education, region of respondent's residence, income-to-poverty ratio, insurance coverage, number of chronic conditions, and survey year. Univariate, bivariate, and multinomial logistic regression analyses were performed.</p><p><strong>Results: </strong>The visits led by PCPs and IM subspecialists declined by 43% and 23% between 2010 and 2021, respectively. However, visits led by NP/PA/RNs increased by 98%. From 2010 to 2021, the proportion of preventive care visits provided by PCPs, IMs, and NP/PA/RNs increased by 25%, 7%, and 4%, respectively. PCPs provided fewer acute and chronic care visits in 2021 than in 2010. Regression analyses illustrated that relative to Non-Hispanic White patients, non-White patients had a higher likelihood of seeing PCPs. Patients reporting 1 chronic condition were more likely to obtain care from an IM or NP/PA/RN than a PCP. In contrast, those with 2 or more chronic conditions had a greater propensity to see PCP than NP/PA/RN.</p><p><strong>Conclusion: </strong>Despite a growing need for primary care services, the decrease in visits to PCPs is concerning and requires further examination. The declining trends in acute and chronic care visits raise questions as to whether primary care, in its current form, can continue to provide its essential attributes and services.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251321618"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Medicaid Expansion on Acute Diabetes Complication by Care Delivery Settings.","authors":"Danielle Kulbak, Dang Dinh, Annie E Larson, Andrew Suchocki, Rachel Springer, Miguel Marino, Jennifer E DeVoe, Jun Hwang, Nathalie Huguet","doi":"10.1177/21501319251320161","DOIUrl":"10.1177/21501319251320161","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates whether gaining Medicaid following the Affordable Care Act (ACA) expansion led to changes in the rate of acute diabetes complications diagnosed in primary care settings, relative to in inpatient, emergency department (ED), or urgent care (UC) settings.</p><p><strong>Methods: </strong>This retrospective cohort study used Medicaid administrative claims data linked to electronic health records for 3767 patients, aged 19 to 64 years, who experienced acute preventable complications of diabetes between 2014 and 2019 diagnosed in inpatient, ED, UC, or primary care settings in the state of Oregon. These patients were classified as either continuously Medicaid-insured or having gained Medicaid.</p><p><strong>Results: </strong>Annual rates of acute complications diagnosed in primary care and inpatient/ED/UC settings increased for both continuously [Adjusted Rate Ratio (aRR) = 2.20, 95% CI = 1.65-2.91] and newly Medicaid-insured patients (aRR = 2.67, 95% CI = 2.05-3.47) after the ACA. Among newly Medicaid-insured, annual rates of abnormal blood glucose diagnosed in primary care settings significantly increased with time while those diagnosed in inpatient/ED/UC decreased (2014 vs 2016 aRR = 3.36, 95% CI = 1.60-7.09).</p><p><strong>Conclusion: </strong>We found a significantly greater rate of abnormal blood glucose diagnosed in primary care clinics among patients who gained Medicaid post-ACA and a corresponding decline in diagnosis in inpatient/ED/UC settings.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251320161"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Prevalence and Predictors of Post-Acute COVID-19 Symptoms in Italian Primary Care Patients\".","authors":"","doi":"10.1177/21501319251341661","DOIUrl":"https://doi.org/10.1177/21501319251341661","url":null,"abstract":"","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251341661"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlating the Socio-Economic Burden of Influenza Infections and the Cost-Benefit of Vaccination in Paediatric Populations.","authors":"Merrin Mathew, Narayanappa Doddaiah, Sakeer Hussain, Nandana Suresh Nambiar, Rovin Mathew Theempalangad, Sinchana Narayanappa, Rattehalli Ashwath Narayan Shrisagar","doi":"10.1177/21501319251332150","DOIUrl":"https://doi.org/10.1177/21501319251332150","url":null,"abstract":"<p><strong>Background: </strong>Influenza in India is increasingly shifting from seasonal outbreaks to an endemic presence with potential pandemic risks. Despite ongoing surveillance to monitor regional virus circulation, it's crucial to assess the unique socio-economic impact of influenza compared to other respiratory illnesses.</p><p><strong>Methodology: </strong>A retrospective study was conducted from October 2023 to October 2024, analysed 3 years of data from a south Indian tertiary care hospital. Children hospitalised with any subtypes of influenza infection were classified as Group 1, while those vaccinated with at least one dose of influenza vaccine from the hospital's immunisation centre formed Group 2. Trends in infection burden and vaccine utilization among paediatric population were detailed, with separate calculations of the economic burden for each group, leading to a summarized cost-benefit analysis.</p><p><strong>Results: </strong>Over three-years, Group 1 included 93 children were with a confirmed positive influenza test, while Group 2 consisted of 453 children who received at least one influenza vaccine at the study site. Hence the study site marked an influenza infection rate of 13.62% and a vaccination rate of 6.93%. Infections were more frequent in children over 1 year (74.19%), while vaccine utilization was highest in those under one (91.83%). Boys had a higher infection rate (65.59%) and demonstrated greater vaccine utilization (56.51%). Vaccine underutilization was evident, with only 1.99% receiving timely boosters, and 23.84% missing them. Infections were more prevalent among middle and lower-income children (86.02%), while vaccination rate was higher in upper income families (81.01%). Vaccination cost was 7.76 times lower than treatment; averaging INR 3252.21 (38.73 USD) per child, compared to treatment at INR 25 237.1 (300.14 USD). Net benefit ranged from INR 611 658.99 to INR 1 135 938.12, based on ±30% wage variations within the study community.</p><p><strong>Conclusion: </strong>The study underscores the economic benefits of influenza vaccination; with costs nearly eight times lower than treatment. However, socio-economic disparities in vaccine utilization emphasize the need for targeted strategies to improve access in lower-income groups.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251332150"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardizing Virtual Healthcare Deployment: Insights From the Implementation of Telerobotic Ultrasound to Bridge Healthcare Inequities in Rural and Remote Communities Across Canada.","authors":"Amal Khan, Sandro Galea, Ivar Mendez","doi":"10.1177/21501319251329314","DOIUrl":"10.1177/21501319251329314","url":null,"abstract":"<p><p>The COVID-19 pandemic has accelerated the integration of virtual care into healthcare systems, presenting a unique opportunity to address healthcare inequities in rural and remote communities, particularly those that are Indigenous. This commentary outlines critical steps and best practices for deploying virtual care in underserved regions, drawing on over a decade of experience in Saskatchewan. Key recommendations include creating detailed community profiles, assessing digital literacy, and using standardized readiness tools to evaluate infrastructure and clinical needs. A weighted prioritization framework ensures efficient resource allocation, while partnerships with Indigenous-led institutions, such as SIIT, equip local healthcare assistants to support virtual care delivery. Examples from successful telerobotic ultrasonography deployments in the rural and remote communities of Saskatchewan highlight the potential of virtual care to improve healthcare access, outcomes, and sustainability. By tailoring interventions to community-specific contexts and involving local stakeholders, <i>virtual care</i> can bridge health disparities and serve as a replicable model for similar settings worldwide.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251329314"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}